The very necessary TL;DR version:
- Split hit points into wound and vitality that do not have individually fixed maximums, but do have a fixed total.
- Wound points effectively reduce maximum hp (until they are healed)
- Vitality is everything else.
- A creature falls unconscious when current hit points (i.e. vitality) equals or falls below current wound damage.
- Adds attrition with minimal balance implications in any single encounter.
- Grittiness (which does change encounter balance) can be added with dials.
- Almost every game element, including other modules, that works with hit points can be used without modification.
- One can ignore the distinction between wounds and vitality and exactly recover traditional hit points.
- Wound damage generated by any die showing its maximum could be very slick.
---
Yesterday after browsing some of the various threads about healing I had what I think is a new idea about how to make hit points work. Perhaps it is only new to me, there are a lot of healing systems to go around. My principal excitement is that I think it could meet the basic preferences of the vitality/wounds crowd and the hit point crowd in an elegantly modular way without affecting single-encounter game balance, and which would be automatically compatible with a wide variety of other modifications that deal with hit points. Mechanically it is has similarities to 3.5's nonlethal damage, but please read on before quitting the thread in disgust!
Most vitality/wound systems tend to set up separate pools for each type of damage, each with their own maximum, and then determine which pool incoming damage (whether all or some) goes into. (For simplicity I'll keep these names.) My idea is to define a single hit point total that does not predefine the size of wounds or vitality pools, but effectively keeps track of both. Vitality damage reduces hit points as normal, while current wound damage sets the threshold at which the creature starts to die and lowers the maximum number of hit points the creature can have. If the target's current hit points equals or falls below its wound damage it would fall unconscious (or die if you rock it old-school). For example, a creature with 50 hit points maximum might have taken 30 hit points of vitality damage (so it has 20 hp) and 10 points of wound damage. If it takes 10 total damage (e.g. 7 vitality and 3 wound) then its current hp equals its wound damage and the creature falls unconscious.
The target's current hit points can't be increased above normal maximum hp minus current wound damage. (A target at full health that takes 5 wound damage would still technically have 50 hp, but the hp between 46-50 are effectively temporary hit points and once lost cannot be regained.) In the example above where the target has 20 hp and 10 wound damage, an effect that heals 25 vitality would actually heal only 20, because 50-10=40. This cap means a creature always take exactly its maximum hit points in damage (whether by wounds or vitality) before falling unconscious, but the actual split of the two is not predefined. Finally, this also lets one say that e.g. the cure spells and natural healing heal wounds, but everything else can just deal with hp as normal. This effectively means a warlord, for example, would only heal vitality points, but we don't actually have to say that anywhere.
This is, in a sense, the minimal change one can make to the hit point system while distinguishing wounds and vitality, and both it and traditional hp should work well with other modules. I don't mean the new module would necessarily have the same impact when combined with either, just that it doesn't have to be aware that the vitality/wound module is in use. For example, suppose a module introduced healing surges. Traditional hp and healing surges would look much like 4e. The vitality/wound system plus healing surges might represent vitality healing over the course of a day (essentially fatigue), but keep wound damage for longer-term attrition. Or one could use a module where hit points are automatically returned to maximum after each encounter. With traditional hp this would work for a very gonzo style game, while with vitality/wounds this would represent the automatic recovery of vitality but keep track of attrition solely as hit points. A module that adds effects and healing-times or healing difficultes for wounds would probably be pretty straightforward to add.
While conceptually similar to most vitality/wound systems, what I'm proposing has a much more flexible notion of just how much damage a person can suffer because only the sum of vitality and wounds is fixed. That is, it makes the distinction between "real wounds" and everything else, but does not define how important they are relative to each other. Thematically a person could be active almost to death's (or unconsciousness') door as long as they have at least one more hit point than wound damage. In this respect it is very much like a traditional hit point system. However, it is probably more typical that the heroes deal with vitality damage, and suffer relatively few wounds. How one determines what damage is wound damage and what is vitality damage will impact the typical balance between these two extremes, of course. In addition, most vitality/wound systems with which I'm familiar try to introduce greater grittiness directly into the game not just through long-term attrition but by occasional attacks that cut to the wound points and may result in sudden death. By default what I've proposed is more likely to make you scarred than instantly decapitated, and as they level up all characters can in principle suffer worse and worse wounds. I can appreciate that has some verisimilitude difficulties, and for those who feel the same it is very easy to add on these other gritty elements. For example, the "dial" that says a character dies if it has wound damage exceeding Con is no more elaborate than that very phrase. As that will have a much larger impact on how the game plays I think it is preferable to turn it on independently.
Like any vitality/wound system, this one plays nicely with many classes having some sort of healing ability, as alluded to earlier. For me that is a big draw, because traditional hit points and plentiful non-magical healing gives me thematic hiccups. Using any vitality/wound system I feel much more free to have every character interact with it, and in distinct ways. (Warlords and bards inspire, fighters learn to temporarily ignore significant wounds, magical healers focus on removing wounds, etc.) People who want to use traditional hp and also leave most healing to time or the cleric might find this distasteful, however. This point of character/class design will be contentious no matter what WotC does, however, so it might not be weakness of this proposal so much as not a strength compared to any other vitality/wound system.
One potential pragmatic weakness of this system is how it instructs one to keep track of damage. By that I mean some people prefer to measure damage taken (adding until reaching some maximum) and others like to track current hp (subtracting until reaching 0). As presented above this system asks people to do both (effectively burning the hit point candle at both ends), rather than just one, which might be annoying for some people. Doing just one method or the other is possible, but it isn't quite as obvious as it is when every pool is fixed and associated with only one type of damage. A person that wants to keep track of vitality damage rather than current hit points could do so by rewriting the rules to say they fall unconscious when vitality damage + wound damage exceeds maximum hp, and vitality healing cannot be reduced below wound damage. A person who wants to subtract from maximums can achieve this by having both types of damage reduce current hp, but keep track of wound damage by (temporarily) changing their maximum hit point score, and fall unconscious at 0 hp. (The latter might be more in keeping with D&D's traditions, now that I think about it.) Also possible is reversing the roles above, namely subtracting wound damage from max hp, keeping track of vitality damage, and going unconscious when vitality damage exceeds current hp. These are all equivalent formulations, but the game would probably need to standardize on one presentation.
Now, how can this system satisfy the traditional hit point crowd? As you've certainly realized by now, this is easily done by ignoring the distinction between vitality and wound damage, which leaves it completely unobtrusive. After all, if wounds aren't a thing then "wound damage" is effectively fixed to 0, and a creature falls unconscious when its current hp is 0. Furthermore, since the maximum number of hit points a creature has is the same whether using vitality/wounds or not, a creature that starts with n hitpoints always falls unconscious after having suffered n net damage. That means two identical parties at full health, each using one of these systems, will essentially be equally balanced in that encounter. (They might have to reshuffle healing around a bit during the fight if only magic healing can heal wounds in battle, and so forth, but that's a second order effect.) Attrition will, of course, affect future encounters, but this version of vitality/wounds just does not introduce many side effects. Compare that to 3.5's vitality and wound alternate system, for example, where the deadliness of many monsters (e.g. those that crit a lot) was dramatically impacted.
Finally, since attrition is usually not a matter of concern for monsters, the DM can use regular hit points for them and vitality/wound points for the PCs quite transparently, with essentially no impact on outcomes. If an enemy has extensive magical healing or is important enough to want to know just how the PCs have hurt him, it can easily be swapped in on a per case basis.
That's the basic idea, let me provide some specifics for how it could work in 5e. Everything below is just rough(er) musing.
How might one introduce wound damage without needing to ever use those words in a stat block? There are lots of options, but I think a very simple one is this: whenever a die shows its maximum, the damage from that die is wound damage. First of all, this means that most attacks will not deal wound damage until multiple dice are involved, so the additional math and record keeping is unobtrusive most turns. Mathematically the expected value is always 1 point of wound damage per die that contributed to the overall damage. A 1d4 weapon and 1d12 weapon therefore have the same expected impact on attrition over time, while a weapon that does 2d6 will average twice as much per attack. This is also nice for spells, sneak attacks, or other things with lots of dice and should therefore be more likely to cause wounds. For example, the 5d6 fireball can be expected to deal 5 wound damage on average. If critical hits impose maximum damage and/or extra dice like in 4e, these also will automatically be more wounding without needing a separate rule. In addition, in almost every battle the expected total party attrition can be readily estimated. This might not be distributed evenly among members (since the actual imposition of a wound on a given attack is fairly swingy and given in 4-12 point chunks) but if the party is overall subject to 40 independent damage dice in a fight, then that is enough to make 40 wound points a reasonable expectation. (I ran a quick simulation: A couple thousand trials of 40 rolls using random d4-d12 with equal probability. The distribution is a good approximation to the normal distribution and the standard deviation is about 17, so roughly 2/3 of the time the total number of wound points dealt in such a fight would be between 23 and 57.) This is almost certainly superior to trying to estimate attrition in terms of the typical total damage dealt to the PCs during a fight, because it directly estimates the damage which counts as attrition, and is valid whether the fight is againt brutes rolling d12s or subtler creatures that do little damage but impose a lot of effects.
The expectation of 1 wound per attack die means vitality will generally play a larger role than wounds. Again assuming all d4-d12 are used equally, on average we roll a d8 which has an expected outcome of 4.5. If dice were the only source of damage then we would expect 1/4.5=2/9, or a little over 20%, of all damage to be wound damage. I'm sure 5e will have non-dice sources of damage that will lower that ratio, and maximizing critical hits raises it again, but unless the non-dice sources of damage are as significant as they are in 4e (which I'd doubt since they have said they want to keep hit point inflation in check) it's probably in the ballpark. One wrinkle is this ratio would also depend on how the number of damage dice used scale with hit points. If the primary source of more damage is more dice (5d6->9d6 fireballs for example) then it will scale somewhat. If additional damage is primarily flat bonuses to reduce rolling, then attrition becomes less important over time. I won't hazard a guess about what 5e actually does.
Another possible advantage of giving wound damage on a maximum damage die is it can provide a useful cue to the DM when describing the action. If every attack did exactly 20% wound damage and 80% vitality damage it doesn't give the DM much inspiration for describing what happened, besides being mathematically inconvenient. Instead, fights are punctuated with wounds, and occasionally really big ones. Furthermore, in these cases the damage is usually part wound and part vitality, so one can get an idea of how important each of these elements is in the description. For example, a 5d6 fireball that does 20 damage could have been 2,3,4,5,6 or 1,1,6,6,6. Both have basically the same impact on the current fight, but the latter might tell a more colorful (and skin-melty) story.
What about how much damage is required for death? As already mentioned one might cause death instead of unconsciousness when hp falls below wound damage, or for extra grit if wound damage exceeds a low threshold. Thematically I like the idea that all damage taken while helpless should be wound damage, and the character dies when wound damage equals normal maximum hit points. I like that a character with 50 hp that falls unconscious with 4 hp (more out-of-gas than wounded) is harder to kill than one who falls unconscious at 40 hp (clearly critically wounded). All of these, however, break the symmetry and therefore the balance with the normal hit point system, so there is something to be said for adapting whatever it uses.
Thank you to those who made it this far! For the time being my eyes have seen about all they can, so I'd appreciate new ones seeking both merits and lurking deadly flaws.
If you hate vitality/wound systems please remember that I'm not asking you to "see the light." Rather, I want to consider whether 5e could be designed and balanced to work with both traditional hit points and this proposal as well as I tentatively think they could.
- Split hit points into wound and vitality that do not have individually fixed maximums, but do have a fixed total.
- Wound points effectively reduce maximum hp (until they are healed)
- Vitality is everything else.
- A creature falls unconscious when current hit points (i.e. vitality) equals or falls below current wound damage.
- Adds attrition with minimal balance implications in any single encounter.
- Grittiness (which does change encounter balance) can be added with dials.
- Almost every game element, including other modules, that works with hit points can be used without modification.
- One can ignore the distinction between wounds and vitality and exactly recover traditional hit points.
- Wound damage generated by any die showing its maximum could be very slick.
---
Yesterday after browsing some of the various threads about healing I had what I think is a new idea about how to make hit points work. Perhaps it is only new to me, there are a lot of healing systems to go around. My principal excitement is that I think it could meet the basic preferences of the vitality/wounds crowd and the hit point crowd in an elegantly modular way without affecting single-encounter game balance, and which would be automatically compatible with a wide variety of other modifications that deal with hit points. Mechanically it is has similarities to 3.5's nonlethal damage, but please read on before quitting the thread in disgust!

Most vitality/wound systems tend to set up separate pools for each type of damage, each with their own maximum, and then determine which pool incoming damage (whether all or some) goes into. (For simplicity I'll keep these names.) My idea is to define a single hit point total that does not predefine the size of wounds or vitality pools, but effectively keeps track of both. Vitality damage reduces hit points as normal, while current wound damage sets the threshold at which the creature starts to die and lowers the maximum number of hit points the creature can have. If the target's current hit points equals or falls below its wound damage it would fall unconscious (or die if you rock it old-school). For example, a creature with 50 hit points maximum might have taken 30 hit points of vitality damage (so it has 20 hp) and 10 points of wound damage. If it takes 10 total damage (e.g. 7 vitality and 3 wound) then its current hp equals its wound damage and the creature falls unconscious.
The target's current hit points can't be increased above normal maximum hp minus current wound damage. (A target at full health that takes 5 wound damage would still technically have 50 hp, but the hp between 46-50 are effectively temporary hit points and once lost cannot be regained.) In the example above where the target has 20 hp and 10 wound damage, an effect that heals 25 vitality would actually heal only 20, because 50-10=40. This cap means a creature always take exactly its maximum hit points in damage (whether by wounds or vitality) before falling unconscious, but the actual split of the two is not predefined. Finally, this also lets one say that e.g. the cure spells and natural healing heal wounds, but everything else can just deal with hp as normal. This effectively means a warlord, for example, would only heal vitality points, but we don't actually have to say that anywhere.
This is, in a sense, the minimal change one can make to the hit point system while distinguishing wounds and vitality, and both it and traditional hp should work well with other modules. I don't mean the new module would necessarily have the same impact when combined with either, just that it doesn't have to be aware that the vitality/wound module is in use. For example, suppose a module introduced healing surges. Traditional hp and healing surges would look much like 4e. The vitality/wound system plus healing surges might represent vitality healing over the course of a day (essentially fatigue), but keep wound damage for longer-term attrition. Or one could use a module where hit points are automatically returned to maximum after each encounter. With traditional hp this would work for a very gonzo style game, while with vitality/wounds this would represent the automatic recovery of vitality but keep track of attrition solely as hit points. A module that adds effects and healing-times or healing difficultes for wounds would probably be pretty straightforward to add.
While conceptually similar to most vitality/wound systems, what I'm proposing has a much more flexible notion of just how much damage a person can suffer because only the sum of vitality and wounds is fixed. That is, it makes the distinction between "real wounds" and everything else, but does not define how important they are relative to each other. Thematically a person could be active almost to death's (or unconsciousness') door as long as they have at least one more hit point than wound damage. In this respect it is very much like a traditional hit point system. However, it is probably more typical that the heroes deal with vitality damage, and suffer relatively few wounds. How one determines what damage is wound damage and what is vitality damage will impact the typical balance between these two extremes, of course. In addition, most vitality/wound systems with which I'm familiar try to introduce greater grittiness directly into the game not just through long-term attrition but by occasional attacks that cut to the wound points and may result in sudden death. By default what I've proposed is more likely to make you scarred than instantly decapitated, and as they level up all characters can in principle suffer worse and worse wounds. I can appreciate that has some verisimilitude difficulties, and for those who feel the same it is very easy to add on these other gritty elements. For example, the "dial" that says a character dies if it has wound damage exceeding Con is no more elaborate than that very phrase. As that will have a much larger impact on how the game plays I think it is preferable to turn it on independently.
Like any vitality/wound system, this one plays nicely with many classes having some sort of healing ability, as alluded to earlier. For me that is a big draw, because traditional hit points and plentiful non-magical healing gives me thematic hiccups. Using any vitality/wound system I feel much more free to have every character interact with it, and in distinct ways. (Warlords and bards inspire, fighters learn to temporarily ignore significant wounds, magical healers focus on removing wounds, etc.) People who want to use traditional hp and also leave most healing to time or the cleric might find this distasteful, however. This point of character/class design will be contentious no matter what WotC does, however, so it might not be weakness of this proposal so much as not a strength compared to any other vitality/wound system.
One potential pragmatic weakness of this system is how it instructs one to keep track of damage. By that I mean some people prefer to measure damage taken (adding until reaching some maximum) and others like to track current hp (subtracting until reaching 0). As presented above this system asks people to do both (effectively burning the hit point candle at both ends), rather than just one, which might be annoying for some people. Doing just one method or the other is possible, but it isn't quite as obvious as it is when every pool is fixed and associated with only one type of damage. A person that wants to keep track of vitality damage rather than current hit points could do so by rewriting the rules to say they fall unconscious when vitality damage + wound damage exceeds maximum hp, and vitality healing cannot be reduced below wound damage. A person who wants to subtract from maximums can achieve this by having both types of damage reduce current hp, but keep track of wound damage by (temporarily) changing their maximum hit point score, and fall unconscious at 0 hp. (The latter might be more in keeping with D&D's traditions, now that I think about it.) Also possible is reversing the roles above, namely subtracting wound damage from max hp, keeping track of vitality damage, and going unconscious when vitality damage exceeds current hp. These are all equivalent formulations, but the game would probably need to standardize on one presentation.
Now, how can this system satisfy the traditional hit point crowd? As you've certainly realized by now, this is easily done by ignoring the distinction between vitality and wound damage, which leaves it completely unobtrusive. After all, if wounds aren't a thing then "wound damage" is effectively fixed to 0, and a creature falls unconscious when its current hp is 0. Furthermore, since the maximum number of hit points a creature has is the same whether using vitality/wounds or not, a creature that starts with n hitpoints always falls unconscious after having suffered n net damage. That means two identical parties at full health, each using one of these systems, will essentially be equally balanced in that encounter. (They might have to reshuffle healing around a bit during the fight if only magic healing can heal wounds in battle, and so forth, but that's a second order effect.) Attrition will, of course, affect future encounters, but this version of vitality/wounds just does not introduce many side effects. Compare that to 3.5's vitality and wound alternate system, for example, where the deadliness of many monsters (e.g. those that crit a lot) was dramatically impacted.
Finally, since attrition is usually not a matter of concern for monsters, the DM can use regular hit points for them and vitality/wound points for the PCs quite transparently, with essentially no impact on outcomes. If an enemy has extensive magical healing or is important enough to want to know just how the PCs have hurt him, it can easily be swapped in on a per case basis.
That's the basic idea, let me provide some specifics for how it could work in 5e. Everything below is just rough(er) musing.
How might one introduce wound damage without needing to ever use those words in a stat block? There are lots of options, but I think a very simple one is this: whenever a die shows its maximum, the damage from that die is wound damage. First of all, this means that most attacks will not deal wound damage until multiple dice are involved, so the additional math and record keeping is unobtrusive most turns. Mathematically the expected value is always 1 point of wound damage per die that contributed to the overall damage. A 1d4 weapon and 1d12 weapon therefore have the same expected impact on attrition over time, while a weapon that does 2d6 will average twice as much per attack. This is also nice for spells, sneak attacks, or other things with lots of dice and should therefore be more likely to cause wounds. For example, the 5d6 fireball can be expected to deal 5 wound damage on average. If critical hits impose maximum damage and/or extra dice like in 4e, these also will automatically be more wounding without needing a separate rule. In addition, in almost every battle the expected total party attrition can be readily estimated. This might not be distributed evenly among members (since the actual imposition of a wound on a given attack is fairly swingy and given in 4-12 point chunks) but if the party is overall subject to 40 independent damage dice in a fight, then that is enough to make 40 wound points a reasonable expectation. (I ran a quick simulation: A couple thousand trials of 40 rolls using random d4-d12 with equal probability. The distribution is a good approximation to the normal distribution and the standard deviation is about 17, so roughly 2/3 of the time the total number of wound points dealt in such a fight would be between 23 and 57.) This is almost certainly superior to trying to estimate attrition in terms of the typical total damage dealt to the PCs during a fight, because it directly estimates the damage which counts as attrition, and is valid whether the fight is againt brutes rolling d12s or subtler creatures that do little damage but impose a lot of effects.
The expectation of 1 wound per attack die means vitality will generally play a larger role than wounds. Again assuming all d4-d12 are used equally, on average we roll a d8 which has an expected outcome of 4.5. If dice were the only source of damage then we would expect 1/4.5=2/9, or a little over 20%, of all damage to be wound damage. I'm sure 5e will have non-dice sources of damage that will lower that ratio, and maximizing critical hits raises it again, but unless the non-dice sources of damage are as significant as they are in 4e (which I'd doubt since they have said they want to keep hit point inflation in check) it's probably in the ballpark. One wrinkle is this ratio would also depend on how the number of damage dice used scale with hit points. If the primary source of more damage is more dice (5d6->9d6 fireballs for example) then it will scale somewhat. If additional damage is primarily flat bonuses to reduce rolling, then attrition becomes less important over time. I won't hazard a guess about what 5e actually does.
Another possible advantage of giving wound damage on a maximum damage die is it can provide a useful cue to the DM when describing the action. If every attack did exactly 20% wound damage and 80% vitality damage it doesn't give the DM much inspiration for describing what happened, besides being mathematically inconvenient. Instead, fights are punctuated with wounds, and occasionally really big ones. Furthermore, in these cases the damage is usually part wound and part vitality, so one can get an idea of how important each of these elements is in the description. For example, a 5d6 fireball that does 20 damage could have been 2,3,4,5,6 or 1,1,6,6,6. Both have basically the same impact on the current fight, but the latter might tell a more colorful (and skin-melty) story.
What about how much damage is required for death? As already mentioned one might cause death instead of unconsciousness when hp falls below wound damage, or for extra grit if wound damage exceeds a low threshold. Thematically I like the idea that all damage taken while helpless should be wound damage, and the character dies when wound damage equals normal maximum hit points. I like that a character with 50 hp that falls unconscious with 4 hp (more out-of-gas than wounded) is harder to kill than one who falls unconscious at 40 hp (clearly critically wounded). All of these, however, break the symmetry and therefore the balance with the normal hit point system, so there is something to be said for adapting whatever it uses.
Thank you to those who made it this far! For the time being my eyes have seen about all they can, so I'd appreciate new ones seeking both merits and lurking deadly flaws.
